Emergency department and transport predictors of neurological deterioration in patients with spontaneous intracranial hemorrhage

Bzhilyanskaya, Vera; Najafali, Daniel; Torre, Olivia M.; Afridi, Leenah; Cao, Tiffany; Panchal, Bhakti; Albelo, Fernando; Karwoski, Allison; Afridi, Ikram; Tran, Quincy

doi:10.1016/j.ajem.2022.01.002

Cited by 2 publications

(3 citation statements)

References 20 publications

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“…[29][30][31] Admission of spontaneous intracranial hemorrhage (sICH) patients to a neurologic ICU is associated with reduced mortality rates. [32] Referring medical centers should thoroughly evaluate the patient prior to transfer as the ideal service at the accepting facility (neurology, neurosurgery, etc.) is determined prior to the transfer of the patient to ensure a quick and smooth transfer of care.…”

Section: Intracranial Hemorrhagementioning

confidence: 99%

“…[34] Transferring facilities need to monitor the maximum systolic blood pressure (SBP max ), as 75% of patients with an SBP max > 240 mmHg develop ND. [32] Prolonged and severe hypertension can contribute to growing intracranial pressure (ICP), increase the risk of sICH, and worsen existing sICH. For this reason, the current guidelines from the American Stroke Association (ASA) [35] state that the SBP of patients with sICH should be reduced to 160 mmHg or less.…”

Section: Intracranial Hemorrhagementioning

confidence: 99%

“…[36] Patients received antiepileptics (P=0.030) and hyperosmolar therapy (P=0.031), with a signifi cantly greater number of ND patients receiving interventions. [32] For the transport crew, the medical control (MC) physician determines the number and type of monitoring devices, such as ICP monitors, and the need for additional staff (i.e., second paramedic, nurse, or physician). ICP monitors need to be observed during the whole transport time to avoid dislodgement of the catheter.…”

Section: Intracranial Hemorrhagementioning

confidence: 99%

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Patient care during interfacility transport: a narrative review of managing diverse disease states

Tran¹,

O’Connell²,

Hakopian³

et al. 2023

World Journal of Emergency Medicine

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BACKGROUND: When critically ill patients require specialized treatment that exceeds the capability of the index hospitals, patients are frequently transferred to a tertiary or quaternary hospital for a higher level of care. Therefore, appropriate and effi cient care for patients during the process of transport between two hospitals (interfacility transfer) is an essential part of patient care. While medical adverse events may occur during the interfacility transfer process, there have not been evidence-based guidelines regarding the equipment or the practice for patient care during transport. METHODS:We conducted searches from the PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and Scopus databases up to June 2022. Two reviewers independently screened the titles and abstracts for eligibility. Studies that were not in the English language and did not involve critically ill patients were excluded. RESULTS:The search identified 75 articles, and we included 48 studies for our narrative review. Most studies were observational studies. CONCLUSION:The review provided the current evidence-based management of diverse disease states during the interfacility transfer process, such as proning positioning for respiratory failure, extracorporeal membrane oxygenation (ECMO), obstetric emergencies, and hypertensive emergencies (aortic dissection and spontaneous intracranial hemorrhage).

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